Transcript of Myocardial Infarction (MI) Overview | Med-Surg | Nursing School | Pathology | Signs & Symptoms

hey there future nurses it's christine from nurse in the making and today we're going to talk about an mi which stands for myocardial infarction this is most commonly known as a heart attack but before we get started don't forget to subscribe to my youtube channel for weekly nursing school videos daily nursing school questions and all things to help you pass nursing school let's break apart the word myocardial infarction myo refers to muscle and cardio means of the heart infarction is an area of dead or dying tissue due to lack of oxygen and blood so when you put it together it means the heart muscle is dying from lack of oxygen now that we've broken apart the word let's talk about the pathophysiology of an mi the heart muscle needs oxygen in order to be able to function and pump blood to the body but if the arteries and the heart muscle become blocked the heart muscle starts to die because it's not receiving oxygen so the heart won't be able to pump blood to the rest of the body well why would the heart become blocked the coronary arteries can become narrowed with a buildup of plaque plaque within the arteries is a collection of cholesterol and cells think of this plaque as sticky and clingy almost like barnacles to a rock except this is sticking to your blood vessel walls which is not good plaque can cause an mi in two different ways the first way is that excessive collection or buildup causing narrowing of the vessels the second way it can cause an mi is that the plaque on the vessel walls can break off and rupture going straight to the heart blocking those main arteries so who is at risk for an mi a patient with a history of coronary artery disease high cholesterol again high cholesterol causes that plaque buildup in the vessels high blood pressure the reason high blood pressure can cause nmi is that high blood pressure damages the vessels which causes stenosis and narrowing a patient with a family history of heart conditions and other causes like stressors and smoking let's talk about some signs and symptoms seen in an mi some people complain of crushing chest pain some patients might describe this as feeling like an elephant is sitting on their chest crushing is a word you definitely want to remember because the nclex loves to throw that word in when talking about an acute mi some other signs and symptoms you'll see is the left arm pain shortness of breath sweating also called diaphoretic the patient may become pale and they may even have nausea and vomiting it's important to know that women may present with different symptoms some are asymptomatic and others show abnormal signs like fatigue shoulder discomfort and even heartburn all these things are just normal everyday life symptoms and it can be really easily overlooked so be on the lookout for these symptoms on nclex questions specifically in women so let's break apart how to diagnose an mi there are two types of myocardial infarctions and these two different types are named by the way they appear on an electrocardiogram or an ekg rhythm strip the first type is a stemi which means an st elevation myocardial infarction the second type is a non-stemi or n-stemi which means a non-st elevation myocardial infarction so for a stemi this occurs when there is a total occlusion of a main coronary blood vessel this will show as an st elevation on an ekg you can remember this by thinking stemi think serious we have a total occlusion so for a non-stemi you obviously won't see an elevated st segment like the name says it just means blood flow is being restricted not stopped for a non-stemi they're usually partial occlusions unlike a stemi which is a total occlusion some other warning signs of an mi can be seen on an ekg so let's look at these scenarios on an ekg you may see an st elevation we know this means total blockage and the muscle is suffocating you may also see sd depression and a t-wave inversion these all indicate injury to the heart diagnosing an mi isn't as simple as diagnosing other diseases this is because there are many ways to diagnose and rule out an acute mi so in addition to obtaining an ekg we want to get troponin levels a troponin level checks for a type of protein called troponin that lives in the heart muscle when the heart muscle is injured or dying this protein releases out into the bloodstream so the more injury to the heart the higher the levels of troponin will be so to summarize if you see an st elevation a stemi or an elevated troponin level on an exam or the nclex you should immediately think acute mi now for the treatment we can remember the treatment with the mnemonic mona mona is not the order in which you do these tasks it's just a mnemonic to help you remember the treatment m is for morphine morphine takes some of the workload off the heart and can relieve pain o is for oxygen because remember the heart is being oxygen deprived so the body needs more oxygen to survive n is for nitroglycerin nitroglycerin is a vasodilator or a drug which opens the vessels to help blood get through a is for aspirin which prevents platelets from collecting and sticking together so once we've given some immediate care we look to the next step thrombolytics also known as clot busters help to break up that occlusion and restore blood flow we are saved by the suffix thrombolytics are easy to remember because they end in the suffix to place and ace some examples are out of place retiplase and streptokinase again these drugs are busting those clots they actually work to break them down and help oxygen and blood feed the heart again some other treatment we commonly see is a cardiac catheterization and patients are often sent straight up to what is referred to as the cath lab here a percutaneous coronary intervention or angioplasty is performed this is a procedure where a thin catheter is inserted into the vessels to rescue the heart it can be done with or without a stent placement a stent is a tiny tubular mesh piece that helps widen a narrowed vessel restoring blood flow back to the heart a more invasive surgery like a cabbage which stands for coronary artery bypass graft aka open heart surgery this may be used to bypass those blocked vessels and divert blood back to the heart the point is all these procedures are trying to restore blood back to the heart there are many medications used when caring for a patient with an mi medications such as thrombolytics again these are our clot busters which we talked about earlier this is an immediate treatment of an mi to break down the clot heparin iv may be administered to prevent another blockage while the heart recovers nitroglycerin which helps the heart to rest it opens the vessels to let blood pass without much resistance beta blockers are used to reduce the pressure and heart's workload and calcium channel blockers are used to relax the heart and let it rest if you want more information on these medications you can find it in the complete nclex pharmacology flashcards prevention of an mi is key because we want to do everything in our power to prevent a heart attack some modifiable factors or ones that can be controlled you want to educate your patient to stop smoking diet changes like lower fat and lower sodium and exercise should be encouraged you also want to educate those patients with high blood pressure to take their blood pressure medications regularly we call these medications anti-hypertensives and for those patients with high cholesterol we want to encourage them to take their anti-hyperlipidemic medications regularly typically these are your statins remember we want to prevent the cholesterol from forming fatty plaque buildups in the vessels all these things can help prevent a heart attack if you found this video helpful don't forget to subscribe to my youtube channel happy studying future nurses you